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    Electrical Stimulation: All Kinds of Choices

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    j1nlaks1c
    Electrical stimulation can be categorized based on voltage and frequency. Different waveforms like monophasic, biphasic, and interferential currents are used. Stimulation can occur at subsensory, sensory, motor, or noxious levels. Subsensory microcurrent aims to restore balance, sensory targets pain gates, motor induces contractions for edema control or muscle reeducation, and noxious causes pain to relieve pain. Parameters vary depending on the desired effect but proper electrode placement and duty cycling are important to optimize outcomes. There are many options for electrical stimulation so practitioners should tailor protocols based on individual needs and responses.

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    Electrical Stimulation: All Kinds of Choices

    Uploaded by

    j1nlaks1c
    150 views33 pages
    Electrical stimulation can be categorized based on voltage and frequency. Different waveforms like monophasic, biphasic, and interferential currents are used. Stimulation can occur at subsensory, sensory, motor, or noxious levels. Subsensory microcurrent aims to restore balance, sensory targets pain gates, motor induces contractions for edema control or muscle reeducation, and noxious causes pain to relieve pain. Parameters vary depending on the desired effect but proper electrode placement and duty cycling are important to optimize outcomes. There are many options for electrical stimulation so practitioners should tailor protocols based on individual needs and responses.

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    Electrical Stimulation (1)

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    Electrical stimulation can be categorized based on voltage and frequency. Different waveforms like monophasic, biphasic, and interferential currents are used. Stimulation can occur at subsensory, sensory, motor, or noxious levels. Subsensory microcurrent aims to restore balance, sensory targets pain gates, motor induces contractions for edema control or muscle reeducation, and noxious causes pain to relieve pain. Parameters vary depending on the desired effect but proper electrode placement and duty cycling are important to optimize outcomes. There are many options for electrical stimulation so practitioners should tailor protocols based on individual needs and responses.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    150 views33 pages

    Electrical Stimulation: All Kinds of Choices

    Uploaded by

    j1nlaks1c
    Electrical stimulation can be categorized based on voltage and frequency. Different waveforms like monophasic, biphasic, and interferential currents are used. Stimulation can occur at subsensory, sensory, motor, or noxious levels. Subsensory microcurrent aims to restore balance, sensory targets pain gates, motor induces contractions for edema control or muscle reeducation, and noxious causes pain to relieve pain. Parameters vary depending on the desired effect but proper electrode placement and duty cycling are important to optimize outcomes. There are many options for electrical stimulation so practitioners should tailor protocols based on individual needs and responses.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 33

    Electrical Stimulation

    All Kinds of Choices


    Stimulating Units
    Fall into one of two categories:

    Low Volt (Less than 100V)
    TENS (9V battery)

    High Volt (Greater than 100V)
    Pretty much everything else
    Carrier Frequencies
    Low-frequency currents
    1000 pps or less (Monophasic, Biphasic)
    Medium-frequency currents
    1000 pps 100,000 pps (IFC, Russian)
    High-frequency currents
    100,000 pps and higher (Diathermies)
    Waveforms
    Monophasic
    Biphasic
    Interferential
    Pre-modulated Interferential
    Russian
    TENS
    Microcurrent
    Monophasic
    Unidirectional flow of electrons
    Negative / Positive polarity
    Twin Peaked Monophasic
    Peak Current
    Pulse Duration
    75 s
    Biphasic
    Positive and Negative Phases
    Symmetrical / Asymmetrical




    Interferential Current
    Two channels at separate frequencies
    Less skin resistance
    Quadripolar Electrode Configuration
    5,000 Hz
    5,100 Hz
    Interferential
    Channel 1
    Channel 2
    Beat Frequency: 100 Hz
    Interference Current
    Ch 1
    Ch 2
    Ch 2
    Ch 1
    Pre-modulated IFC
    Bipolar electrode configuration
    Mixing of currents occurs inside the machine
    Less penetration than IFC
    Russian
    Classical Russian Stim involves 2500 Hz carrier
    frequency w/ beat frequency from 1 100 Hz
    Thought to allow more current to reach motor
    nerve at lower intensities
    Results have never been duplicated
    TENS
    Transcutaneous Electrical Nerve Stimulation
    Primarily used for pain reduction
    Gate Control
    Endogenous-opiate release
    Microcurrent
    Subsensory or very low sensory level
    Very small current amperage / Very high pulse duration
    Very theoretical / not much supporting research
    Attempts to re-establish bodys natural electrical balance by
    allowing ATP supply to increase metabolic energy for
    healing to occur
    Levels of Electrical Stimulation
    Subsensory
    Sensory
    Pain Relief
    Edema Control
    Motor
    Pain Relief
    Edema Control
    Muscle Re-education
    Noxious
    Subsensory
    Microcurrent
    Unable to stimulate nerve or muscle
    Variety of recommended parameters
    Generally consists of 2 10 minute Txs
    Parameters
    1
    st
    Treatment
    Frequency: 30 Hz
    Intensity: 600 A

    2
    nd
    Treatment
    Frequency: .3 Hz
    Intensity : 60 A
    Lynn Wallace

    Pain Mode
    Frequency: 30 Hz
    Intensity: 80-100 A
    Healing Mode
    Frequency: .3 Hz
    Intensity: 20-40 A
    Sensory Level Pain Relief
    Stimulation at or above sensory threshold
    but below motor level
    Stimulation of A fibers
    Gate Control Theory
    Frequency: 50 150 Hz
    Phase Duration: Less than 100 s
    Intensity: Comfortably strong
    Sensory Level Edema Control
    Done immediately following injury to limit
    formation of edema
    Not widely researched but a few theories
    Decreased capillary pressure and permeability
    which keeps plasma and proteins from entering
    extracellular tissues
    Vascular spasm preventing leaking from
    vessels
    Waveform: Monophasic
    Frequency: 120 pps
    Phase Duration: As high as possible
    Intensity: Comfortably strong
    Monopolar electrode configuration
    Negative electrodes over injured area

    Motor Level Pain Control
    Best used with subacute / chronic pain
    Endogenous opiate release
    Longer duration of pain relief

    Also good for trigger points
    Frequency: Low; 2-4 pps
    Phase Duration: Wide; 200-300 s
    Intensity: Strong, twitch contractions

    Motor Level Edema Control
    Muscular contractions encourage venous
    and lymphatic milking fluids from the
    area
    Electrodes arranged to follow primary vein
    exiting swollen area
    May be continuous or on / off time
    Continuous

    Frequency: 1 2pps
    (or as low as possible)
    Phase Duration:
    200 400 s
    Intensity:
    Strong, twitch contractions
    On / Off time

    Frequency: 25 50pps
    Phase Duration:
    200 400 s
    Intensity:
    Strong, tonic contractinons
    Duty Cycle: 50%
    5 on / 5 off
    10 on / 10 off
    Muscle Re-education
    Neuromuscular Electrical Stimulation (NMES)
    Muscle re-education, reduction of spasticity, delay
    of atrophy, muscle strengthening
    Stronger type of current, not as comfortable as
    other forms of ES
    Not as effective as voluntary contractions
    Frequency: 25 50 pps
    Phase Duration: 200 400 s
    Intensity: Strong tonic contractions

    NMES Principles
    Duty Cycle
    1:5 (10 on / 50 off) Strength
    1:2 (10 on / 20 off) Endurance
    1:1 (10 on / 10 off) Fatigue
    Ramp Times
    Fast ramp on: .5 1 sec Power
    Long ramp on: 1 2 sec Strength
    Long ramp off: 3 5 sec Eccentrics
    Noxious Stimuli
    Causing pain to relieve pain
    Stimulation of A and C fibers
    Electrode placement is variable
    Generally used as a last resort
    Longer lasting pain relief
    Frequency: 1-5 pps or 80-100 pps
    Phase Duration: 1 ms or higher
    Intensity: Noxious (painful)
    Conclusion


    Lots of machines, lots of choices.
    Everybody is different, so dont be afraid to
    try different things if things arent going as
    planned.

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